Speech by A/Prof Benjamin Ong, Director of Medical Services, at the Public Health Service 2017, 21 October 2017

Associate Professor Lau Tang Ching,

Vice-Dean (Education), Yong Loo Lin School of Medicine, National University of Singapore

Ladies and gentlemen

        Good morning. It gives me great pleasure to join you at the NUS Yong Loo Lin School of Medicine’s 12th Public Health Service (PHS) event today.

SHIFTING OUR EFFORTS UPSTREAM AND IN THE COMMUNITY

2.     As you are aware, with our ageing population, by 2030, one in four Singaporeans will be aged 65 years and above. This means potentially more individuals at risk of developing chronic diseases such as diabetes, dementia and cancer. The burden of caring for affected individuals usually falls on their families and the community. The Ministry of Health (MOH) has increasingly focused efforts to help Singaporeans with upstream preventive measures.

3.     Diabetes is a major public health concern as one in three Singaporeans will develop diabetes during their lifetime, with about 400,000 Singaporeans currently living with diabetes. We declared war on diabetes because of this concern.

4.     A high proportion of Singaporeans have undiagnosed diabetes and many diabetics do not manage their conditions well. This situation increases the downstream risk of many complications, such as blindness, heart attacks, stroke, kidney failure and lower limb amputations. Taking active steps to get screened and making changes to our lifestyle can address these risks. The Diabetes Risk Assessment (DRA) tool, which is accessible on HealthHub, seeks to help individuals, especially younger adults aged 18 to 39 years, assess their current risk for undiagnosed diabetes as well as whether they should go for diabetes screening. Using this tool, individuals can check if they are at increased risk of developing diabetes, and step forward to be screened.

5.     We have also been increasingly promoting healthy living. Our Health Promotion Board (HPB) has implemented a broad range of initiatives to nudge people to live better. The Healthier Dining Programme is one such example. HPB has worked tirelessly to bring on board restaurants, food courts, hawker centres and coffee shops to increase the availability of affordable and healthier food options. For the busy Singaporean with no time to cook, it is now easier to eat better with more than 3,000 touch points islandwide offering healthier options. Regular exercise may be difficult for the time-conscious Singaporean. But by leveraging smartphone and wearable technology, HPB’s National Steps Challenge has seen half a million participants taking steps in the right direction.

6.     We have sought to make evidence-based screening more accessible and affordable. To encourage more Singaporeans to attend recommended screenings and follow up, MOH has enhanced subsidies for the HPB’s Screen for Life (SFL) programme since 1st September this year. Eligible Singaporeans can go for screening and one post-screening consultation, for chronic conditions such as diabetes, hypertension and hyperlipidaemia, and selected cancers such as colorectal and cervical cancers, at a small fixed fee of no more than $5. The fee is even lower at $2 for Community Health Assist Scheme (CHAS) cardholders. Pioneers need not pay.

7.     At this juncture, I would like to commend the efforts of our student volunteers and supporters in partnering with us to promote screening. 43% of all screening participants at last year’s PHS event were found to have abnormalities in at least one of the cardiovascular health indicators. This placed them at a higher risk for conditions such as heart attacks and strokes. Regular and age-appropriate screening can enable the early detection of risk factors such as diabetes and hypertension, and allow prompt intervention to prevent or delay the onset of related complications. Students participating in these community screening outreach programmes can play a part to educate the screening participants whom they interact with, about their risks and need for screening.

EMPOWERING COMMUNITIES AND INDIVIDUALS TO CHOOSE BETTER

8.     Going for screening is important and so is following up with your family doctor on the results. We want to anchor screening in primary care and have Singaporeans see a regular family doctor. In line with MOH’s key shift to move beyond hospitals into the community, we are also forming Primary Care Networks (PCNs), which are networks of like-minded General Practitioners (GPs) who are provided with the necessary support and resources to provide holistic and team-based chronic care to patients in the community. The newly formed PCNs are targeted to be operational in early 2018.

9.     As we step up efforts to strengthen our primary care system, there is a need for better public understanding regarding chronic conditions and awareness of the health resources available. I am encouraged by how the PHS has grown and expanded its outreach over the years. The PHS started modestly over a decade ago with just four items at its inaugural screening event. Today, it serves more than 1,300 participants in the community at each PHS. The PHS has also educated and empowered students from secondary schools and junior colleges to become champions in promoting health in their own communities through its Young Health Ambassadors’ Programme (YHAP).

10.    Even as the government works to provide a supportive environment to nudge Singaporeans to make healthier choices, health is ultimately a personal responsibility. We Singaporeans need to take the initiative to undergo health checks and screenings in order to reap the benefits. An individual needs to regularly follow up with their GP and maintain a healthy lifestyle to prevent ill health, rather than wait for a health crisis, when it may be too late. It is crucial every Singaporean be empowered to take responsibility for their own health and not remain indifferent on its importance.

11.     In closing, I would like to thank the NUS Yong Loo Lin School of Medicine for organising this event, and I wish you all good health. Thank you.